It is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or in those on immunosuppressive drugs.

Its early manifestations resemble diffuse otitis externa but there is excruciating pain and appearance of granulations in the meatus. Facial paralysis is common. Infection may spread to the skull base and jugular foramen causing multiple cranial nerve palsies. Anteriorly, infection spreads to temporomandibular fossa, posteriorly to the mastoid and medially into the middle ear and petrous bone.

CT scan is useful, to know the extent of disease.

Treatment consists of high doses of i.v. antibiotics directed against pseudomonas (tobramycin, ticarcillin or third generation cephalosporins). Antibiotics are given for 6-8 weeks or longer. Diabetes should be controlled. Surgical debridement of devitalised tissue and bone should be done judiciously.

Q. 2

Malignant otitis externa results from infection by which of the following organisms

A

Klebsiella

B

Enterococcus

C

Pseudomonas aeroginosa

D

Strep tococcal pneumonia

Q. 2

Malignant otitis externa results from infection by which of the following organisms

A

Klebsiella

B

Enterococcus

C

Pseudomonas aeroginosa

D

Strep tococcal pneumonia

Ans.

C

Explanation:

Pseudomonas aeroginosa

Q. 3

Which of the following is true regarding malignant otitis externa?

A

Caused by pseudomonas

B

Seen in elderly diabetics

C

Granulation tissue may be present in the external auditory canal

D

All the above

Q. 3

Which of the following is true regarding malignant otitis externa?

A

Caused by pseudomonas

B

Seen in elderly diabetics

C

Granulation tissue may be present in the external auditory canal

D

All the above

Ans.

D

Explanation:

Q. 4

Which of the organism causes malignant otitis externa?

A

Staphylococcus aureus

B

Pseudomonas aeruginosa

C

Candida albicans

D

E. coli

Q. 4

Which of the organism causes malignant otitis externa?

A

Staphylococcus aureus

B

Pseudomonas aeruginosa

C

Candida albicans

D

E. coli

Ans.

B

Explanation:

Malignant (necrotizing) otitis externa is a particularly aggressive life-threatening form of infection caused by Pseudomonas aeruginosa infection. It usually in the elderly diabetics, or in those on immunosuppressive drugs. Its early manifestations resemble diffuse otitis externa but there is excruciating pain and appearance of granulations in the meatus. Facial paralysis is common.

Q. 5

Which of the following is NOT a typical feature of malignant otitis externa?

A

Caused by Pseudomonas aeruginosa

B

Patients are usually old

C

Mitotic figures are high

D

Patient is immunocompromised

Q. 5

Which of the following is NOT a typical feature of malignant otitis externa?

A

Caused by Pseudomonas aeruginosa

B

Patients are usually old

C

Mitotic figures are high

D

Patient is immunocompromised

Ans.

C

Explanation:

High mitotic figures are suggestive of a malignant pathology. Malignant otitis externa is an infective condition, not a malignant one.

Q. 6

External otitis is also known as:

A

Glue ear

B

Malignant otitis externa

C

Telephonists ear

D

ASOM

Q. 6

External otitis is also known as:

A

Glue ear

B

Malignant otitis externa

C

Telephonists ear

D

ASOM

Ans.

C

Explanation:

Humidity and hot climate are one of the predisposing factors for otitis externa. Hence – otitis externa is also k/a Singapore ear (where climate is hot & humid) or Telephonist ear as talking on phone causes humidity around ear) or Swimmers ear.

Pseudomonas aeruginosa is a normal inhibitant of external ear. Its numbers are kept in balance by the normal acidity of EAC. Prolonged swimming or abusive use of cotton typed ear buds can alter the pH, producing a more basic environment in which pseudomonas grows rapidly.

Q. 7

Malignant otitis externa is caused by:

A

S. aureus

B

S. albus

C

P. aeruginosa

D

E. coli

Q. 7

Malignant otitis externa is caused by:

A

S. aureus

B

S. albus

C

P. aeruginosa

D

E. coli

Ans.

C

Explanation:

Ans. is c is P. aeruginosa

Q. 8

True statement about malignant otitis externa is:

A

Not painful

B

Common in diabetics and old age

C

Caused by streptococcus

D

All of the above

Q. 8

True statement about malignant otitis externa is:

A

Not painful

B

Common in diabetics and old age

C

Caused by streptococcus

D

All of the above

Ans.

B

Explanation:

Q. 9

Malignant otitis externa is:

A

Malignancy of external ear

B

Caused by hemophilus influenzae

C

Blackish mass of aspergillus

D

Pseudomonas infection in diabetic patient

Q. 9

Malignant otitis externa is:

A

Malignancy of external ear

B

Caused by hemophilus influenzae

C

Blackish mass of aspergillus

D

Pseudomonas infection in diabetic patient

Ans.

D

Explanation:

Q. 10

Malignant otitis externa is characterized:

A

Caused by pseudomonas aeruginosa

B

Malignancy of external auditory canal

C

Granulation tissue is seen in the floor of external auditory canal

D

a and c

Q. 10

Malignant otitis externa is characterized:

A

Caused by pseudomonas aeruginosa

B

Malignancy of external auditory canal

C

Granulation tissue is seen in the floor of external auditory canal

D

a and c

Ans.

D

Explanation:

Q. 11

An elderly diabetic presents with painful ear discharge and edema of the external auditory canal with facial palsy, not responding to antibiotics. An increased uptake on technetium bone scan is noted. The most probable diagnosis is

A

Malignant otitis externa

B

Malignancy of the middle ear

C

Infective disease of the middle ear

D

Malignancy of nasopharynx with Eustachian tube ob­struction

Q. 11

An elderly diabetic presents with painful ear discharge and edema of the external auditory canal with facial palsy, not responding to antibiotics. An increased uptake on technetium bone scan is noted. The most probable diagnosis is

A

Malignant otitis externa

B

Malignancy of the middle ear

C

Infective disease of the middle ear

D

Malignancy of nasopharynx with Eustachian tube ob­struction

Ans.

A

Explanation:

Q. 12

Facial nerve palsy is seen in:

A

Seborrheic otitis externa

B

Otomycosis

C

Malignant otitis externa

D

Eczematous otitis externa

Q. 12

Facial nerve palsy is seen in:

A

Seborrheic otitis externa

B

Otomycosis

C

Malignant otitis externa

D

Eczematous otitis externa

Ans.

C

Explanation:

Q. 13

A female diabetic having severe ear pain and granulation tissue in external ear with Facial palsy is due to:

A

Malignant otitis externa

B

Herpes zoster otitis

C

Otomycosis

D

None

Q. 13

A female diabetic having severe ear pain and granulation tissue in external ear with Facial palsy is due to:

A

Malignant otitis externa

B

Herpes zoster otitis

C

Otomycosis

D

None

Ans.

A

Explanation:

Malignant otitis externa – can cause destruction of tissues of canal, pre and post auricular region by various enzymes like leci­thinase and hemolysis.

Infection can spread to skull base and jugular foramen causing multiple cranial nerve palsies in which most common is facial nerve palsy.

Q. 14

Diffuse otitis externa is also known as:

A

Glue ear

B

Malignant otitis externa

C

Telephonist’s ear

D

ASOM

Q. 14

Diffuse otitis externa is also known as:

A

Glue ear

B

Malignant otitis externa

C

Telephonist’s ear

D

ASOM

Ans.

C

Explanation:

Q. 15

Regarding necrotizing otitis externa all are true except:

A

Caused by pseudomonas

B

Surgery never done

C

Facial nerve involved

D

Common in diabetics

Q. 15

Regarding necrotizing otitis externa all are true except:

A

Caused by pseudomonas

B

Surgery never done

C

Facial nerve involved

D

Common in diabetics

Ans.

B

Explanation:

Q. 16

Facial nerve palsy is seen in this condition:

A

Seborrheic otitis externa

B

Otomycosis

C

Malignant otitis externa

D

Cerebellar abscess

Q. 16

Facial nerve palsy is seen in this condition:

A

Seborrheic otitis externa

B

Otomycosis

C

Malignant otitis externa

D

Cerebellar abscess

Ans.

C

Explanation:

Q. 17

A 75-year old diabetic patient presents with severe ear pain and granulation tissue at external auditory canal with facial nerve involvement. The most likely diagnosis is:

A

Malignant otitis externa

B

Nasopharyngeal carcinoma

C

Acute suppurative otitis media

D

Chronic suppurative otitis media

Q. 17

A 75-year old diabetic patient presents with severe ear pain and granulation tissue at external auditory canal with facial nerve involvement. The most likely diagnosis is:

A

Malignant otitis externa

B

Nasopharyngeal carcinoma

C

Acute suppurative otitis media

D

Chronic suppurative otitis media

Ans.

A

Explanation:

Q. 18

Causative organism for malignant otitis externa is

A

Hemophilus

B

Staphylococcus

C

Streptococcus

D

Pseudomonas

Q. 18

Causative organism for malignant otitis externa is

A

Hemophilus

B

Staphylococcus

C

Streptococcus

D

Pseudomonas

Ans.

D

Explanation:

Malignant/necrotizing otitis externa is a disorder involving inflammation and damage of the bones and cartilage at the base of the skull.

Malignant otitis externa is caused by the spread of an outer ear infection (otitis externa, also called swimmer’s ear). It is an uncommon complication of both acute swimmer’s ear and chronic swimmer’s ear.

Risks for this condition include:

Chemotherapy

Diabetes

Weakened immune system

External otitis is often caused by difficult-to-treat bacteria such as pseudomonas. The infection spreads from the floor of the ear canal to the nearby tissues and into the bones at the base of the skull.

The infection and inflammation may damage or destroy the bones. The infection may spread more and affect the cranial nerves, brain, or other parts of the body.

It is an uncommon form of external otitis occurs mainly in elderly diabetics.

It can develop due to a severely compromised immune system.

Beginning as infection of the external ear canal, there is extension of infection into the bony ear canal and the soft tissues deep to the bony canal.

The hallmark of malignant otitis externa (MOE) is unrelenting pain that interferes with sleep and persists even after swelling of the external ear canal may have resolved with topical antibiotic treatment.

Natural history

MOE follows a much more chronic and indolent course than ordinary acute otitis externa.

There may be granulation involving the floor of the external ear canal, most often at the bony-cartilaginous junction.

Paradoxically, the physical findings of MOE, at least in its early stages, are often much less dramatic than those of ordinary acute otitis externa.

In later stages there can be soft tissue swelling around the ear, even in the absence of significant canal swelling. While fever and leukocytosis might be expected in response to bacterial infection invading the skull region, MOE does not cause fever or elevation of white blood count.

When MOE goes unrecognized and untreated, the infection continues to smolder and over weeks or months can spread deeper into the head and involve the bones of the skull base, constituting skull base osteomyelitis (SBO). The infecting organism is almost always pseudomonas aeruginosa, but it can instead be fungal (aspergillus or mucor).

MOE and SBO are not amenable to surgery, but exploratory surgery may facilitate culture of unusual organism(s) that are not responding to empirically used anti-pseudomonal antibiotics.

The usual surgical finding is diffuse cellulitis without localized abscess formation. SBO can extend into the petrous apex of the temporal bone or more inferiorly into the opposite side of the skull base.

Complications

As the skull base is progressively involved, the adjacent exiting cranial nerves and their branches, especially the facial nerve and the vagus nerve, may be affected, resulting in facial paralysis and hoarseness, respectively.

If both of the recurrent laryngeal nerves are paralyzed, shortness of breath may develop and necessitate tracheotomy.

Profound deafness can occur, usually later in the disease course due to relative resistance of the inner ear structures

Q. 20

Sago grain appearance is seen in â€‘

A

Healed myringitis bullosa

B

Otomycosis

C

Malignant otitis externa

D

Keratosis obturans

Q. 20

Sago grain appearance is seen in â€‘

A

Healed myringitis bullosa

B

Otomycosis

C

Malignant otitis externa

D

Keratosis obturans

Ans.

A

Explanation:

Ans. is ‘a’ i.e., Healed myringitis bullosa

Otitis externa haemorrhagica

This condition is also known as Bullous myringitis or myringitis bullosa.

This condition is extremely painful and has sudden onset.

It is thought to be due to mycoplasma pneumoniae or viral infection, usually influenza’.

There may be a mild conductive deafness and a mildly discharging car.

The appearance of haemorrhagic bullae on the tympanic membrane and in the deep meatus is characteristic. The bullae are filled with serosanguinous fluid and blood.

On healing, bullae look like Sago-grain.

Therefore “Sago-grain” appearance of tympanic membrane is seen in healed myringitis bullosa.

Q. 21

Malignant otitis externa is caused by â€‘

A

S. aureus

B

S. albus

C

P. aeruginosa

D

E. coli

Q. 21

Malignant otitis externa is caused by â€‘

A

S. aureus

B

S. albus

C

P. aeruginosa

D

E. coli

Ans.

C

Explanation:

Ans. is ‘c’ i.e., P. aeruginosa

Malignant otitis externa

Malignant otitis externa, also called necrotizing external otitis, is a misnomer as it is not a neoplastic condition, rather it is an infectious condition. Malignant otitis externa is a disorder involving inflammation and damage of the bones and cartilage at the base of skull in temporal bone as a result of spread of infection from outer ear. Malignant otitis externa is often caused by difficult to treat bacteria such as pseudomonas aeruginosa. Only rare cases of malignant otitis externa due to S.aureus, Proteus mirabilis and Aspergillus fumigatus have been reported. The infection spreads from the floor of the ear canal to the nearby tissues and into the bones at the base of the skull. The infection and inflammation may damage or destroy the bones. The infection may spread more and affect the cranial nerves, brain, or other parts of the body.

Predisposing factors for malignant otitis externa

Elderly diabetics (most common predisposing factor)

Individuals with altered immune function (immunodeficiency)

Chemotherapy

Clinical features of malignant otitis externa

Severe pain :- inside the ear and may get worse when moving head.

Granulation tissue in the external auditory canal, at the junction of bony and cartilagenous part.

In all cases, the external ear canal is cleansed and a biopsy specimen of the granulation tissue sent for culture. IV antibiotics is directed against the offending organism. For Pseudomonas aeruginosa, the most common pathogen, the regimen involves an antipseudomonal penicillin or cephalosporin (3′d generation piperacillin or ceftazidime) with an aminoglycoside. A fluoroquinolone antibiotic can be used in place of the aminoglycoside. Ear drops containing antipseudomonal antibiotic e.g. ciproflaxacin plus a glucocorticoid is also used. Early cases can be managed with oral and otic fluoroquinolones only. Extensive surgical debridement once an important part of the treatment is now rarely needed.

Q. 22

Fowl smelling ear discharge with presence of pale granulation tissue in ear in an adolescent boy is suggestive of â€‘

A

Cholesteatoma

B

Exostosis

C

Otomycosis

D

Malignant otitis externa

Q. 22

Fowl smelling ear discharge with presence of pale granulation tissue in ear in an adolescent boy is suggestive of â€‘

A female in the emergency department is found to have CSF rhinorrhea following a motor vehicle accident. What is the first line of treatment for CSF rhinorrhoea in this patient?

A

Immediate plugging of nose with petroleum gauze

B

Forceful blowing of nose

C

Craniotomy

D

Observation for 7 – 10 days with antibiotic therapy

Q. 4

A female in the emergency department is found to have CSF rhinorrhea following a motor vehicle accident. What is the first line of treatment for CSF rhinorrhoea in this patient?

A

Immediate plugging of nose with petroleum gauze

B

Forceful blowing of nose

C

Craniotomy

D

Observation for 7 – 10 days with antibiotic therapy

Ans.

D

Explanation:

Early cases of post-traumatic CSF rhinorrhea are managed conservatively by placing the patient in semi-sitting position, avoiding blowing of nose, sneezing and straining. Prophylactic antibiotics are also administered to prevent meningitis.

– Early cases of post traumatic CSF rhinorrhea are managed conservatively. Only those cases where CSF rhinorrhea occurs persistently

– Surgical management should be done

Q. 7

Immediate treatment of CSF rhinorrhea requires:

A

Antibiotics and observation

B

Plugging with paraffin guage

C

Blowing of nose

D

Craniotomy

Q. 7

Immediate treatment of CSF rhinorrhea requires:

A

Antibiotics and observation

B

Plugging with paraffin guage

C

Blowing of nose

D

Craniotomy

Ans.

A

Explanation:

Early cases of post traumatic CSF rhinorrhea are managed conservatively (by placing the patient in propped up position, avoiding blowing of nose, sneezing and straining) and

Prophylactic antibiotics (to prevent meningitis).

Persistent cases are treated surgically by nasal endoscopy or by intracranial route.

Endoscopic closure of (SF leak is now the treatment of choice in majority of patients but it should not be done immediately. First patient should be subjected to diagnostic evaluation and after site of leakage is confirmed, it should be closed endoscopically. – Scott-Brown

Q. 8

Management of persistent cases of CSF rhinorrhea is:

A

Head low position on bed

B

Endoscopic repair

C

Straining activities

D

All of the above

Q. 8

Management of persistent cases of CSF rhinorrhea is:

A

Head low position on bed

B

Endoscopic repair

C

Straining activities

D

All of the above

Ans.

B

Explanation:

CSF rhinorrhoea

It refers to the drainage of cerebrospinal fluid through the nose.

Measures of CSF components such as beta-2 transferrin has been shown to have a high positive predictive value.

It has also been noted to be characterized by unilateral discharge.

It is a sign of basal skull fracture.

Management includes watchful waiting – leaks often stop spontaneously; if this does not occur then neurosurgical closure is necessary to prevent the spread of infection to the meninges.

Q. 9

CSF rhinorrhoea is due to the fracture of which of the following

March 2008

A

Nasal bones

B

Cribriform plate

C

Temporal bone

D

Maxillary bone

Q. 9

CSF rhinorrhoea is due to the fracture of which of the following

March 2008

A

Nasal bones

B

Cribriform plate

C

Temporal bone

D

Maxillary bone

Ans.

B

Explanation:

Ans. B: Cribriform Plate

CSF rhinorrhoea can follow a head injury.

CSF from anterior cranial fossa reaches the nose by way of cribriform plate, ethmoid air cells or frontal sinus. CSF from middle cranial fossa reaches the nose via sphenoid sinuses.

Sometimes, injuries of the temporal bone result in leakage of CSF into the middle ear and thence via the Eustachian tube into the nose (otorhinorrhoea).

The meninges are torn and cerebrospinal fluid leaks down the nose.

Ascending infection may cause meningitis

Q. 10

True about CSF rhinorrhea:

UP 09

A

Commonly occurs due to break in cribriform plate

B

Contains less amount of proteins

C

Decreased glucose content confirms diagnosis

D

Immediate surgery is required

Q. 10

True about CSF rhinorrhea:

UP 09

A

Commonly occurs due to break in cribriform plate

B

Contains less amount of proteins

C

Decreased glucose content confirms diagnosis

D

Immediate surgery is required

Ans.

A

Explanation:

Ans. Commonly occurs due to break in cribriform plate

Q. 11

CSF rhinorrhea is diagnosed by:

MP 07

A

Glucose estimation

B

Halo sign

C

Immunoelectrophoresis

D

All

Q. 11

CSF rhinorrhea is diagnosed by:

MP 07

A

Glucose estimation

B

Halo sign

C

Immunoelectrophoresis

D

All

Ans.

D

Explanation:

Ans. All

Q. 12

Diagnostic test for CSF rhinorrhea is â€‘

A

Beta – 2 microglobulin

B

Beta – 2 transferrin

C

Thyroglobulin

D

Transthyretin

Q. 12

Diagnostic test for CSF rhinorrhea is â€‘

A

Beta – 2 microglobulin

B

Beta – 2 transferrin

C

Thyroglobulin

D

Transthyretin

Ans.

B

Explanation:

Ans. is ‘b’ i.e., Beta-2 transferrin

Q. 13

Common site for CSF Rhinorrhoea is â€‘

A

Ethmoidal sinus

B

Frontal sinus

C

Petrous

D

All

Q. 13

Common site for CSF Rhinorrhoea is â€‘

A

Ethmoidal sinus

B

Frontal sinus

C

Petrous

D

All

Ans.

A

Explanation:

The cribriform plate and air cells of the ethmoid sinus account for maximum number of CSF leaks, i.e., through anterior cranial fossa.

Other sites are frontal sinus, area of sellatursica and sphenoid sinus.

Rare sites of leak are middle or posterior cranial fossa and CSF can reach the nasal cavity by way of the middle ear and Eustachian tube.

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SCAPULA

The muscles of scapula which function as retractors are given below, EXCEPT?

A

Trapezius

B

Rhomboid major

C

Rhomboid minor

D

Levator scapulae

Q. 1

The muscles of scapula which function as retractors are given below, EXCEPT?

A

Trapezius

B

Rhomboid major

C

Rhomboid minor

D

Levator scapulae

Ans.

D

Explanation:

Three muscles make up of retractors of the scapula. They are,

Rhomboid major

Rhomboid minor (The rhomboid muscles attach to the spinous processes of C7–T5 and the medial border of the scapula, resulting in scapular retraction)

Middle fibers of trapeziuscourse horizontally from the lower nuchal ligament and thoracic vertebrae to the scapula, causing scapular retraction.

These muscles primarily tug the shoulder blade back toward the vertebral column. The levator scapula muscle is located deep to the trapezius muscle and superior to the rhomboids causing elevation and downward rotation of the scapula.

Q. 2

All of the following muscles elevate scapula, EXCEPT?

A

Trapezius

B

Levator scapulae

C

Latissimus dorsi

D

Rhomboid major

Q. 2

All of the following muscles elevate scapula, EXCEPT?

A

Trapezius

B

Levator scapulae

C

Latissimus dorsi

D

Rhomboid major

Ans.

C

Explanation:

The latissimus dorsi acts on the humerus causing powerful adduction, extension, and medial rotation of the arm.

The levator scapula muscle attaches to the cervical vertebrae and the superior angle of the scapula, causing elevation and downward rotation of the scapula.

The rhomboid muscles attach to the spinous processes of C7–T5 and the medial border of the scapula, resulting in scapular retraction also also helps in elevation of scapula.

Q. 3

Which is the muscle that draws the scapula forward ?

A

Trapezuis

B

Rhomboides

C

Serratus anterior

D

Levator scapulae

Q. 3

Which is the muscle that draws the scapula forward ?

A

Trapezuis

B

Rhomboides

C

Serratus anterior

D

Levator scapulae

Ans.

C

Explanation:

Serratus anterior protracts the scapula, it acts as a main muscle in reaching and pushing movements. It also helps in raising the arm fully. The muscular digitations of serratus anterior can be seen and felt when the outstretched hand pushes against resistance. In case of paralysis, the lower angle of the scapula stands out prominently, there is projection of scapula also termed as winging of scapula.

Must know:

Seratus anterior is innervated by the long thoracic nerve also known as nerve of bell.

Good to know:

Dropped shoulderoccurs as a result of paralysis of the trapezius muscle. With paralysis of the trapezius muscle a drop shoulder with rotation of the angle of the scapula towards the midline and restricted abduction of the arm is caused. Trapezius is supplied by accessory nerve.

Q. 4

All of the following muscles are used for the retraction of scapula, EXCEPT?

A

Trapezius

B

Rhomboideus major

C

Rhomboideus minor

D

Levator scapula

Q. 4

All of the following muscles are used for the retraction of scapula, EXCEPT?

A

Trapezius

B

Rhomboideus major

C

Rhomboideus minor

D

Levator scapula

Ans.

D

Explanation:

The levator scapula muscle attaches to the cervical vertebrae and the superior angle of the scapula, causing elevation and downward rotation of the scapula.

Trapezius elevates, retracts, depresses, and rotates scapula. The rhomboid muscles attach to the spinous processes of C7–T5 and the medial border of the scapula, resulting in scapular retraction.

Q. 5

The spine of the scapula can be palpated at which of the following level of vertebrae?

A

T 1

B

T 3

C

T 5

D

T 7

Q. 5

The spine of the scapula can be palpated at which of the following level of vertebrae?

A

T 1

B

T 3

C

T 5

D

T 7

Ans.

B

Explanation:

Spine of the scapula lies at the level of T3 vertebrae. Scapular spine is seen on the posterior surface of the scapula and it expands into a terminal process called acromion process.

The scapulae overlie the posterior portion of the thoracic wall, and cover the upper seven ribs. The superior angle of scapula can be palpated at the T1 vertebral level and the inferior angle lies at the level of T7 vertebrae.

“The medial border, inferior angle and part of the lateral border of scapula can be palpated on a patient as can the spine and acromian. The superior border and angle of the scapula are deep to soft tissue and are not readly palpable”

Q. 8

Superior angle of scapula lies at which level â€‘

A

T7

B

T12

C

T2

D

C5

Q. 8

Superior angle of scapula lies at which level â€‘

A

T7

B

T12

C

T2

D

C5

Ans.

C

Explanation:

Ans. is ‘c’ i.e., T2

Q. 9

Winging of scapula is seen in paralysis of which muscleâ€‘

A

Serratus anterior

B

Supraspinatus

C

Pectoralis major

D

Infraspinatus

Q. 9

Winging of scapula is seen in paralysis of which muscleâ€‘

A

Serratus anterior

B

Supraspinatus

C

Pectoralis major

D

Infraspinatus

Ans.

A

Explanation:

Ans. is ‘a’ i.e., Serratus anterior

Q. 10

Congenital elevation of scapula is called â€‘

A

Sprengelshouder

B

Bouchard

C

Boutennier

D

None of the above

Q. 10

Congenital elevation of scapula is called â€‘

A

Sprengelshouder

B

Bouchard

C

Boutennier

D

None of the above

Ans.

A

Explanation:

Ans. is ‘a’ i.e., Sprengel shoulder

Congenital high scapula (sprengel’s shoulder)

Congenital high scapula is an uncommon congenital deformity characterized by an abnormally high position and relative fixity of scapula.

The anomaly represents a failure of the scapula to descend during development to its normal thoracic position.

Q. 11

Patient presented with this condition of scapula in the clinic ,it is due involvement of?

A

Medial pectoral nerve palsy

B

Lateral pectoral nerve palsy

C

Nerve to serratus anterior palsy

D

Nerve to Latissimus dorsi palsy

Q. 11

Patient presented with this condition of scapula in the clinic ,it is due involvement of?

A

Medial pectoral nerve palsy

B

Lateral pectoral nerve palsy

C

Nerve to serratus anterior palsy

D

Nerve to Latissimus dorsi palsy

Ans.

C

Explanation:

Winging of scapula

The most common cause of scapular winging is serratus anterior paralysis.

This is typically caused by damage to the long thoracic nerve.

This nerve supplies the serratus anterior, which is located on the side of the thorax and acts to pull the scapula forward

Q. 12

All of the following muscles are used for this action of scapula as seen in image, EXCEPT?

A

Trapezius

B

Rhomboideus major

C

Rhomboideus minor

D

Levator scapula

Q. 12

All of the following muscles are used for this action of scapula as seen in image, EXCEPT?